Psychoanalytisch begründete Ans?tze in der forensischen Psychiatrie und Psychotherapie

After many years where manualized mainly behaviour treatments dominated in forensic settings, psychodynamic therapies are gaining acceptance and are performed and evaluated more and more in forensic hospitals and in prisons. This encompasses individual, couple, family and group therapies. Individual and group analysts are starting to perform these tasks again, mostly as workers in forensic settings but also as external therapists and supervisors. All staff members are important in creating a therapeutic community based on group analytic principles. They are therefore required to build up a therapeutic attitude supported by regular external case and team supervision. Delictogenic situations occur in everyday life as well as in professional settings and are analysed mainly in group therapies, considering situations of the past and the effect on other people. Modern manualized analytical concepts, such as transference-focussed psychotherapy (TFP) and mentalization-based therapy (MBT) depthen the quality of therapeutic work of all professionals in forensic settings. The multimorbid and sometimes dangerous patients require good ethical and professional attitudes. The psychoanalytic concepts of defence and resistance, transference and countertransference are essential parts of changing internalization and corrective emotional experience, important parts of useful forensic treatments.     

Zur Theorie und Praxis psychoanalytisch begründeter station?rer Psychotherapie

In the last 50 years inpatient psychosomatic psychotherapeutic treatment in Germany has undergone a special development in which the psychoanalytical and group analytical communities were substantially involved. This development will be analyzed in a review with respect to models of the clinical application of psychoanalytical treatment principles. Particular emphasis is placed on the analysis of transference and countertransference processes in a clinical multiperson situation and the resulting necessity of group and teamwork. Only such an integrative inpatient psychotherapy concept is from a psychoanalytical perspective in a position to utilize the interactional, scene-like restaging in a multiperson relationship field and to benefit therapeutically, by which the group analytical function of the team process plays a special role. The practical aspects of two applications of the integrative model in Essen and Dortmund will be presented and the results will be discussed.     

Die Auswirkungen der Wende 1989 auf Adoleszente

The significance of adolescence for psychosocial development is a controversial theme with discussions ranging from an emphasis on the importance of early childhood to the ideas propagated by Freud that the dynamics of adolescence play an important role in the psychological development of the individual and transculturation. The course of adolescence provides a starting point for understanding the psychodynamics of patients, which is often given insufficient consideration. Today, it can repeatedly be seen that patients in their mid-thirties are coming for treatment: patients who experienced their adolescence during the period of political upheaval in Germany. For a variety of reasons this proves to have been a vulnerable life phase, above all for East Germans. Puberty and adolescence comprise developmental tasks whose completion in a crisis situation, such as represented by the political change in East Germany with the reunification process, suffered considerably. Accordingly, the consequences of this conflict-laden coping process can be revealed during later therapy in transference and central relationship conflicts. The adolescents made considerable efforts to adapt to the new conditions, however, without adolescent altercations with GDR parents and conditions having taken place in sufficient measure. The treatment of a female patient is presented for whom the political change during adolescence proved to be a critical life event. Her narcissistic deficits together with her fragile identity were exacerbated as a result of the social upheavals. It is demonstrated how this ??critical life event?? was intertwined with her earlier psychological structure, the problems of adolescence and her search for identity during the course of psychoanalysis.     

Gibt es ein weibliches ?quivalent zur m?nnlichen Perversion?

Starting with the new definition of paraphilia as planned for the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) it will be shown that the topic cannot be handled without a structural definition of the former perversion. Using the most advanced definition for male perversions it will be investigated if there are female counterparts covering the same structural deficits and pseudosexual solutions. This is done using an interpretation by Beyer of a fairy tale from the brothers Grimm which can be considered as typical for these solutions. The basic clinical background will be exemplified using several long-term psychoanalytical cases of women during which it became clear that the creation and destruction of children??s lives is an equivalent to the reparative function of the sexual act in the male perversion, temporarily stabilizing an extremely vulnerable narcissistic structure. It will be discussed whether there are other structural equivalents of perverse solutions, for example taking power of the child??s or the own body as in anorexia or Munchhausen by proxy syndrome.